Provider Demographics
NPI:1881021574
Name:METROPOLITAN UNIVERSAL HOME CARE
Entity Type:Organization
Organization Name:METROPOLITAN UNIVERSAL HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CASE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:TELICIA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HODGES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-795-5448
Mailing Address - Street 1:19111 W 10 MILE RD
Mailing Address - Street 2:SUITE #220-A
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-2417
Mailing Address - Country:US
Mailing Address - Phone:248-795-5448
Mailing Address - Fax:248-213-6400
Practice Address - Street 1:19111 W 10 MILE RD
Practice Address - Street 2:SUITE #220-A
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-2417
Practice Address - Country:US
Practice Address - Phone:248-795-5448
Practice Address - Fax:248-213-6400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-26
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI67382Medicaid